Who’s getting sick? Report sheds new light on breakthrough cases and vaccine protection against hospitalization

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As Ontario tries to keep the resurgence of COVID-19 cases under control, New data from Public Health Ontario shows that only nine fully vaccinated people under the age of 60 have ended up in the ICU.

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The report offers the most detailed picture ever of breakthrough cases – and those becoming very ill despite full vaccinations – showing that the majority of people who need hospital care are over the age of 60. are adults, with the highest proportion in their 80s.

Experts say the findings underscore that vaccines are working well to prevent infection and hospitalization. But they also support opening up a third dose of the COVID vaccine to more older adults, and highlight why masking and other public health measures are still important to protect the most vulnerable at this stage of the pandemic. .


“It is clear that the vaccines are working exceptionally well,” said Dr. Isaac Bogoch, an infectious disease specialist and a former member of Ontario’s now defunct Vaccine Task Force.

“But if you look at all the successful cases, there’s a higher chance that older people will have more serious infections.” Based on this and data from other parts of the world, “it makes sense to extend the eligibility for the third dose to the 50-year-old age group and above.”

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The third dose has been widely opened in the US and Israel, but only a small number of groups in Ontario qualify, including health care workers, individuals age 70 and older, two doses of AstraZeneca or one dose of Johnson & Johnson, and indigenous people. Are included. , Inuit and Metis adults. You must be 168 days before your second dose to take the third dose. Immunocompromised people, transplant recipients, patients with hematological cancer, and seniors living in collective settings, such as long-term care homes, retirement homes, and First Nations elderly care lodges are also eligible.

The Public Health Ontario report, which includes COVID vaccination and case data as of November 14, shows that there were only 17,596 success cases out of 11.1 million individuals who have completed two doses of the vaccine. As of November 14, there were just 40 cases after the third dose, the data shows.

Dr. Sarah Wilson, A. Public Health Physician at Public Health Ontario said in an email to Star.

As of November 14, unvaccinated individuals in Ontario accounted for 91 percent of COVID cases, with 3.8 percent of cases being successful infections. Public Health Ontario defines a successful case as “persons who have received two doses of a COVID-19 vaccine and were infected more than two weeks after receiving their second dose,” Wilson said.

The report said a similar trend was observed for COVID hospitalizations and deaths “with 90.9 percent of hospitalization cases and 90.2 percent of deaths, while 2.7 percent of breakthrough cases were hospitalized.” were responsible for admissions and 3.3 percent of deaths.” As of 14 November, 178 fully vaccinated individuals had died of a COVID infection.

While data shows that older adults are at higher risk of hospitalization from a successful infection – particularly those over the age of 80 – “compared to fully vaccinated individuals who are hospitalized.” The rate was higher among non-vaccinated individuals.”

Wilson said the data makes it clear that the risk of COVID infection is higher for people who have not been vaccinated. For those 60 and older, the risk of hospitalization from the virus was about 16 times higher for non-vaccinated individuals than for those receiving two doses.

Dr Jan Chagla, an associate professor at McMaster University, said only nine intensive care unit admissions in people under the age of 60 are “quite remarkable”, but “the opposite side of the coin though people over 60 need a booster dose.” “

Especially since the global vaccine supply is still strained and there are people in some countries who still don’t have access to the first and second doses, “you want to make sure that[the third dose]is used in those people.” Where they’re going to get the most.

Lucy Gerardi, who soon turns 68, will be first in line if a third dose is opened for her age group.

“You just want that extra sense of security,” said the retired biology teacher and Oakville resident. As of Tuesday, it’s been 168 days since her second shot and she’s trying to get public health officials to know more about when she might get her third, to no avail.

“You’re just in limbo,” Gerardi said.

“But I think we should be grateful that we have at least two shots, when there are people in the world who don’t have any.”

About 420,000 third doses have been given in Ontario, up from 290,000 last week, according to health ministry spokesman Bill Campbell. These numbers will soon be publicly reported. “Ontario plans to gradually expand eligibility for booster doses to all Ontarians over time,” he said in an emailed statement. For now, in line with Recommendations of the National Advisory Committee on Immunization (NACI)They are being offered to vulnerable populations, Campbell said.

Dr. Abdu Sharqawi, an infectious disease specialist with the University Health Network, said that while data from Ontario shows that COVID vaccines work very well, they still do not provide complete protection.

“The message conveyed by this report should not be one of nihilism, that vaccines do not work well enough,” he said. “Vaccines work very well, but they have their limitations.”

So maintaining public health measures, especially masking and reducing the risks that come with crowded, poorly ventilated indoor spaces, is still important, even with highly immunocompromised populations. , Sharkawi said.

“We have to maintain a sense of vigilance about things that can prevent people at risk from getting sick. And that means stopping the chances of a successful infection by not relying solely on vaccines.”

Wilson said Public Health Ontario will publish further reports on breakthrough infusions “that can be used to inform third-dose rollout” and that researchers will be looking at data on different age groups and timing of infections after the second dose. are.

May Warren is a Toronto-based breaking news reporter for Star. Follow him on Twitter: @maywarren11
Megan Ogilvy is a Toronto-based health reporter for Star. Follow him on Twitter: @megan_ogilvie

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